Majority Of Suicides Caused By Depression: San Mateo County Times

September 14, 2007 at 8:12 pm | Posted in Uncategorized | Leave a comment

Abuse. Loneliness. A stressful episode. The unexpected loss of a loved one.

Any of those and other strong physical or emotional factors could trigger suicidal thoughts, especially in already depressed people who don’t seek help either because they don’t know better or are afraid to admit they need it.

“It’s sort of a worldwide phenomenon,” said Dr. Nancy Pena, Santa Clara County’s mental health director. “In many cultures, personal distress and personal suffering, especially if it’s of the mind and the emotions, is not considered a legitimate illness, and there are expectations that people should take care of these problems by themselves and not seek help.

“I think particularly in Western culture, where there is more emphasis on self-sufficiency and independence, people think that it’s a sign of weakness to show that they have emotional problems and are suffering in some way.

People think that they should snap out of it and that it is all in their mind and they should be able to fix it.”

Each year, 30,000 people fail to “fix it” and end up killing themselves. More than 90 percent of them have mental illnesses — usually depression — that could have been treated, experts say.

There are biological reasons why people experience depression and significant evidence that biochemical imbalances exist in people’s brains.

Fortunately, suicide rates have been declining since 1997 due to an increase in the recognition of warning signs, an awareness of prevention measures, more people seeking and having access to treatment, and a plethora of antidepressants on the market, said Dr. Mark J. Goldblatt, assistant clinical professor of psychiatry at Harvard University and president of the New England Chapter of the American Foundation for Suicide Prevention.

“We know that both drugs and psychotherapy in combination is the best treatment,” Goldblatt said. “Once the depression is treated, suicide usually resolves itself.”

And while not all depression requires medication, Pena said, “it certainly does indicate that it’s not just people’s thought process; it actually does affect ourselves physically.”

Suicide and depression cut across all ethnic groups, Goldblatt said. Elderly Caucasian males, however, have the highest suicide rates. Older adults in general are prone to suicide because they often are isolated, experts say.

While women attempt suicide more often, males are four times more likely to kill themselves, according to the American Foundation for Suicide Prevention. “Attempts are cries for help. They want someone to give them attention,” said Amanda Freeman, manager of San Mateo County’s Crisis Center, a program run by the private nonprofit Youth and Family Enrichment Services.

While adults often show outward or behavioral signs of depression, youth do not. But changes in a youth’s clothing fashion or music style could mean a shift in how he or she is feeling on the inside, Freeman said.

“Situational depression related to emotional situations in kids’ lives becomes very sort of amplified for young people and they really oftentimes don’t have the ability to see that things won’t be the same tomorrow or next week,” Pena said.

In many suicides, a precipitating event was devastating to an individual — the loss of a job, or of a loved one. While life-altering events likely aren’t the sole cause of suicide, they could be exacerbated by drugs or alcohol, according to many experts.

Other risk factors include previous suicide attempts and a family history of suicide. People who are widowed or divorced, particularly if they live alone, have a higher rate of suicide than those in other sociological groups. Those who know someone who died by suicide are more likely to attempt or complete suicide.

Though the overall suicide rate has been falling nationwide, the numbers are climbing for some groups.

According to a report released Sept. 6 by the U.S. Centers for Disease Control and Prevention, the suicide rate for children and young adults grew 8 percent in 2004.

“This is the biggest annual increase that we’ve seen in 15 years. We don’t yet know if this is a short-lived increase or if it’s the beginning of a trend,” said Dr. Ileana Arias, director of CDC’s National Center for Injury Prevention and Control.

“Either way, it’s a harsh reminder that suicide, and suicide attempts, are affecting too many youth and young adults. We need to make sure suicide-prevention efforts are continuous and reaching children and young adults.”

The report didn’t speculate on the reasons behind the increase, but it coincides with a drop in the use of antidepressant drugs by young people after the Food and Drug Administration announced it would require antidepressant makers to place a “black box” label warning that the drugs increase the risk of suicidal thoughts and behaviors in children and adolescents, the Wall Street Journal reported.

There also has been a spike in the rate of military people who kill themselves.

In an Aug. 16 news article, the Associated Press reported that Army soldiers in 2006 committed suicide at the highest rate in 26 years. The Army attributes that to repeated and longer deployments, which puts increasing pressure on relationships and military families.

There were 99 Army suicides last year — nearly half of them soldiers who hadn’t reached their 25th birthdays, about a third of them while serving in Iraq or Afghanistan.

Col. Elspeth Ritchie, psychiatry consultant to the Army surgeon general, told a Pentagon press conference the primary reason for suicide is “failed intimate relationships, failed marriages.”

Members of the military may have undiagnosed depression when they return from the war, Goldblatt said, adding that many suffer from post-traumatic stress disorder, which can occur following a traumatic event.

“Depression and mental illness strike any number of people,” said Dr. Rona Hu, an assistant professor of psychiatry at the Stanford University School of Medicine, where she is also medical director of the acute psychiatric inpatient unit. “You’re not a bad person because you’re affected by it,” she said.

While depression and suicide can affect anyone, Hu said Asians also are at high risk.

“There is truth to the idea that Asians are less likely to go for help, and less likely to comply with treatment recommendations,” Hu said.

And the figures are overwhelming in some Asian countries. Japan has the second-highest suicide rate in the industrialized world 25.5 per 100,000 people in 2003. Russia has the highest rate — 38.7 percent — according to World Health Organization statistics.

In a personal or business failing, Asians often feel the only alternative is suicide, Hu said. “In Asian culture, there is a saying, ‘death before dishonor,'” Hu adds. “In Asian society, there’s such an emphasis on saving face. Seeking help seems like a moral failing.”

Over the years, Hu has treated many Asian patients and said that on the surface, they are compliant. “Even if they’re not taking the medications (I have prescribed), they won’t tell me. With depression, there is a sense of shame, a stigma.”

According to the American Foundation for Suicide Prevention, every 16 minutes someone in the United States dies by suicide, leaving others to try and make sense of it.

Goldblatt and other experts urge people to seek help if they or someone they know is contemplating suicide.

“People should take it seriously when their loved ones talk about wanting to die,” Goldblatt said.

“These illnesses are treatable.”

Hu agrees that if suicide is more openly discussed, more people might seek treatment, which could eventually lead to fewer people taking their lives.

“Depression and suicide affect so many people. It’s so stigmatized, but yet so common. If we all could come together and talk about it, we could help each other,” Hu said. (Jamie Casini/San Mateo County Times)


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